CONTINUING HEALTH CARE COVERAGE RESOURCES

COBRA – Employers who have 20 or more employees and provide an employee health plan (whether insured or self-insured) are required by federal law to offer identical coverage to covered employees or qualified beneficiaries if coverage is lost due to any of the following qualifying events: (a) employee’s death; (b) voluntary or involuntary termination or reduction of hours; (c) divorce or separation; (e) a dependent child ceasing to be a dependent under applicable plan provisions; (f) the employer’s filing for a Chapter 11 bankruptcy petition. Qualified beneficiaries must have the option of choosing either/or medical benefits (core coverage) and vision and dental (non-core coverage) and have 60 days from the qualifying event to elect coverage. Coverage available under COBRA can be as long as 36 month, but in any event will not be less than 18 months. Qualified beneficiaries are required to make timely payment for coverage.

CAL-COBRA – Employers who have 2 to 19 employees and provide an employee health plan (whether insured or self insured) are required by state law to offer identical coverage to covered employees or qualified beneficiaries if coverage is lost due to a qualifying event (essentially the same as those for COBRA). Qualified beneficiaries must have the option of choosing either/or medical benefits and vision and dental and have 60 days from the qualifying event to elect coverage. Qualified beneficiaries are required to make timely payment for coverage. Unlike COBRA, Health Plans (Insurers) have primary responsibility administering CAL-COBRA.

FMLA –The Family and Medical Leave Act 1993 (FMLA) pertains to Employers with 50 or more employees and provides “eligible” employees; (a) the right to take unpaid leave, or paid leave if it has been earned, for a period of up to 12 workweeks in any 12 months because of the birth of a child or the placement of a child for adoption or foster care, the employee is needed to care for a family member (child, spouse or parent) with a serious health condition, or the employee’s own serious health condition makes the employee unable to do his or her job; (b) An employee on FLMA leave is also entitled to have health benefits maintained while on leave; (c) An employee generally has a right to return to the same position or an equivalent position with equivalent pay, benefits and working conditions at the conclusion of the leave; (d) the employer has a right to 30 days advance notice for the employee where practicable.

HIPAA- The Health Insurance Portability and Accountability Act (HIPAA) makes it possible for people to get coverage when they have past or present medical problems, and it helps people maintain the coverage they need when they change insurance or jobs. Basically, medical coverage is guaranteed to an eligible employee if he/she has had a minimum of 18 months of continuous health coverage most recently under an employer-sponsored group health plan, has exhausted COBRA or CAL-COBRA, and has had coverage within the last 62 days.
For more information on COBRA, FMLA and HIPPA contact the U.S. Department of Labor’s Pension and Welfare Benefits Administration in San Francisco @ 866-4-USA-DOL or www.dol.gov or www.insurance.ca.gov  

AIM – Access for Infants and Mothers (AIM) provides low-cost health insurance to pregnant women and their infants who are not eligible for no cost Medi-Cal or health insurance. The AIM Program is part of California’s efforts to increase health care for mothers and their infants. Eligibility is determined by family income every year. For more information contact Healthcare Alternatives @ 1-800-433-2611 or www.mrmip.ca.gov  916-324-4695


HEALTHY FAMILIES PROGRAM – The Healthy Families Program provides low-cost medical, dental and vision insurance for children ages 1 to 19 (Adults July 2002?) statewide whose parents hold minimum-wage or low-paying jobs. These working families make too much money to qualify for Medi-Cal, but typically do not get insurance through employers and cannot afford private insurance premiums.
For more information contact Healthy Families @ 1-800-880-5305 or www.healthyfamilies.ca.gov/ .

MRMIP (Major Risk Medical Insurance Plan) www.mrmib.ca.gov 916-324-4695.

CA Department of Social Services
800-925-5253 or 916-327-1400 (24 hr. hotline in English and Spanish offering general information about Medi-Cal, Child Support, SSI, MediCare, SS Retirement, Disability, CalWorks, Cash Assistance, Food Stamps, Protection Services, CMSP, MISP, Health Families, Children Services etc.)